Peters Franziska, Ritz Jörg-Peter
Klinik für Allgemein- und Viszeralchirurgie, Helios Kliniken Schwerin, Wismarsche Str. 393-397, 19055, Schwerin, Deutschland.
Chirurgie (Heidelb). 2025 Oct;96(10):833-836. doi: 10.1007/s00104-025-02344-6. Epub 2025 Jul 11.
Chilaiditi's sign is a rare, usually asymptomatic anatomical variant in which a segment of the colon, most commonly the transverse colon, is interposed between the diaphragm and the liver. This interposition can be misinterpreted as a pneumoperitoneum on radiographic imaging, which therefore poses diagnostic challenges. While many cases are discovered incidentally and require no treatment, symptoms such as abdominal pain, nausea or constipation can occur. In such cases, the condition is referred to as Chilaiditi's syndrome. The causes are multifactorial and include liver atrophy, colonic redundancy or ligamentous laxity. The treatment depends on the symptoms: conservative management is the primary approach and surgical interventions are rarely necessary. Differentiated radiological diagnostics are essential to avoid complications.